Ensuring Health Equity for Asian Americans, Native Hawaiians & Pacific Islanders through Healthy People 2020 & the Affordable Care Act

According to Healthy People 2020, health equity occurs when all people have the opportunity to achieve their full health potential and no one is disadvantaged from achieving this potential because of their socially determined circumstance. While the Affordable Care Act (ACA) expands health care coverage and affordability for Asian Americans, Native Hawaiians, and Pacific Islanders (AAs and NHPIs), there are limits expanding health care coverage for these populations. Due to the well-documented ethnic, linguistic, and socioeconomic diversities among AAs, and also between AAs and NHPIs, some subgroups are likely to face greater barriers than others in accessing health care under the ACA. ACA's failure to mandate coverage for all employers may disproportionately affect AAs and NHPIs, many of whom work in small businesses that are exempt from the mandate. State-based health benefit exchanges, intended to provide qualified coverage for such individuals, may be underutilized by AAs and NHPIs with limited English proficiency. Moreover, the ACA may further exclude some immigrants and their children from accessing health care including AAs and NHPIs subject to the “five-year bar” that restricts lawful permanent residents from accessing public health insurance programs and the prohibition on undocumented immigrants from buying coverage in the insurance exchanges. The promise of health care reform will not be fulfilled without comprehensive immigration reform, or a lift on the restrictions that unfairly deny newer legal immigrants access to health care. We will propose how national and local organizations representing diverse groups might work together to address common challenges.